Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation.

Posterior decompression salvages Bryan total disc arthroplasty in post-operatively recurrent uncoforaminal stenosis.

We report on 69 retrospectively reviewed patients who received 73 Bryan (Medtronic Sofamor Danek, Memphis, TN, USA) total disc arthroplasties for recent soft cervical disc herniations over a 9.3year period. Three patients returned with radiculopathy due to the redevelopment of uncoforaminal stenosis at the Bryan segment and later underwent posterior decompression of the uncoforaminal area without modification to the prosthesis.

A 6.5-year follow-up of 14 patients who underwent ProDisc total disc arthroplasty for combined long-standing degenerative lumbar disc disease and recent disc herniation.

A highly selected cohort of nine women and five men (mean age±standard error of the mean, 39.6±10.2 years) with discogenic low-back pain (duration: 75.

Bryan total disc arthroplasty: a replacement disc for cervical disc disease.

Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthesis, its indications, surgical technique, complications, and outcomes, as given in the literature.

Fluoronavigation-assisted, lumbar vertebroplasty for a painful Schmorl node.

Lumbar Schmorl nodes usually remain asymptomatic. Painful nodes either heal spontaneously or respond to conservative therapy in most instances. Diagnosis and treatment may be difficult in patients presenting with chronic back pain.

Bryan cervical disc prostheses: preservation of function over time.

Preserving the function of cervical disc prostheses, even over the short term, is a matter of concern among surgeons. Our case series highlights our results and protocol for increasing the probability of continued device function. Twenty-five consecutive patients with a mean (+/-SEM) age of 44.

Vertebroplasty combined with pedicular instrumentation.

Osteoporosis and cancer patients may suffer sudden severe back pain due to vertebral body osteolysis, microfractures and/or compression fractures. These patients need immediate restabilisation of the vertebral body to eliminate the pain generator, to prevent further crushing, and to reduce the comorbidity of prolonged immobilisation. Vertebroplasty combined with pedicular instrumentation is presented as a therapy for a selected group of such patients.

Intradural extramedullary arachnoid cyst of the thoracic spine associated with cord compression.

In this report, a 55-year-old Caucasian women with an arachnoid cyst of the thoracic spine is presented. This cyst remained undiagnosed because of the nonspecific nature of her symptoms over approximately three months. Only when she started to complain of ataxia, a posterior fluid collection compressing the spinal cord was found in MRI.

Double-segment Wilhelm Tell technique for anterior lumbar interbody fusion in unstable isthmic spondylolisthesis and adjacent segment discopathy.

The Wilhelm Tell technique is a novel instrumented anterior lumbar interbody fusion (ALIF) procedure using a specially designed composite carbon fibre cage and a single short-threaded cancellous screw that obliquely passes through the upper adjacent vertebral body, the interbody cage itself and through the lower adjacent vertebral body. This single-stage fusion method, which is in principle a combination of the Louis technique and modern cage surgery, is reported to have a lower rate of pseudoarthrosis formation than stand-alone cage techniques. In addition, it eliminates both the surgical trauma of paravertebral muscle retraction and the risk of neural damage by poorly located pedicular screws.

A novel surgical treatment of lumbar disc herniation in patients with long-standing degenerative disc disease.

Object: In patients with long-standing lumbar degenerative disc disease (DDD) conventional surgical therapy of a herniated disc may worsen back pain due to further destabilization of the affected motion segment. In recent years, total-disc arthroplasty has been introduced to treat DDD while maintaining segmental mobility. To the best of the authors' knowledge, this is the first report involving lumbar disc herniation and long-standing DDD submitted to combined anterior microdiscectomy with sequestrectomy and total-disc arthroplasty.

Salvage of gastric restriction following staple-line dehiscence after vertical banded gastroplasty by insertion of an adjustable gastric band.

Background: Vertical banded gastroplasty (VBG) has been a common and safe surgical treatment for morbid obesity. However, the complication of staple-line dehiscence (SLD) results in VBG failure. We present a minimally invasive revision procedure when SLD occurs: gastric restriction is salvaged by adjustable gastric banding (AGB), usually laparoscopically, providing that the previous restriction had achieved sufficient weight loss initially and was well-tolerated.

Long-term outcome in 132 consecutive patients after posterior internal fixation and fusion for Grade I and II isthmic spondylolisthesis.

Object: The authors assessed the late outcome of patients with Meyerding Grade I and II isthmic spondylolisthesis (IS) who underwent posterior instrumentation and posterolateral fusion (PLF). Decompression and posterior internal fixation with PLF is the classic surgical treatment for painful low-grade IS. Nevertheless, outcome data are scarce and of limited value mainly because they represent small numbers of patients, short follow-up periods, or both.

Post-traumatic cervical kyphosis with surgical correction complicated by temporary anterior spinal artery syndrome.

Post-traumatic undiagnosed disco-ligamentous and osseous lesions of the cervical spine may eventually result in irreducible extreme kyphosis. Correction of such consolidated deformities requires major surgery with a combined posterior and anterior approach, aiming to correct bony impingement on neural and vascular structures, reduce deformity and to attain circumferential instrumentation and fusion in physiological alignment. This can be achieved using either a single-staged or a two-staged procedure.

Vertebroplasty for metastasis.

Vertebral metastases are frequently asymptomatic; however, the occurrence of a pathological (micro-)fracture may be associated with unremitting pain, instability, and even kyphoscoliotic deformity and require prompt and effective treatment. In symptomatic patients, the beneficial effect of conservative therapies requires too much time. Vertebroplasty (VP) may be an additional or even alternative local treatment modality for such patients.

The Wilhelm tell technique for anterior lumbar interbody fusion. Technical note.

Experience indicates that stand-alone cages may lack the necessary stability to secure highly unstable motion segments at the lumbosacral junction. The authors have designed a special carbon fiber composite interbody cage that allows additional screw placement in anterior lumbar interbody fusion procedures performed at the lumbosacral junction.

[Vertebroplasty and kyphoplasty:a review].

Only recently, vertebroplasty (VP) and kyphoplasty (KP) were introduced in the treatment of lesions of the vertebral body (VB). Most frequently, osteoporotic fractures (VP, KP) and metastases (VP) are treated in highly selected patients. These methods consist of polymethylmethacrylat (PMMA) injection into the VB usually through transpedicular canulas.

[Monosegmental , degenerative, cervical discopathy treated by surgery with insertion of an intervertebral cage].

Monosegmental, degenerative, cervical discopathy may become symptomatic because of spinal instability or neurocompression and may present as cervicalgia, radiculopathy and myelopathy. Conservative therapy of these conditions is indicated only in case of minor symptoms. In patients with radiculopathy, this treatment may be used for a longer period of time than in individuals with myelopathy.

Late recurrence of pineal germinoma.

Background: Cerebral germinomas and their occasional recurrences can usually be cured by irradiation, chemotherapy, or a combination of the two treatment modalities. Late recurrences, as in our case, are distinctly rare.

Case Description: This patient presented at age 24 with a calcified tumor in the pineal area.